Tympanometric gradient measured from normal preschool children.

Tympanometric gradient is a quantitative expression of the shape of a tympanogram in the vicinity of the peak. Previous work suggests that gradient measures may be diagnostically and prognostically useful in the assessment and management of middle ear disease. However, since almost all previous work on the subject was performed on tympanograms recorded in 'arbitrary compliance units' which are not comparable to the physical admittance units provided by currently available instrumentation, at this point the tympanometric gradient can only be viewed to be a potentially-useful clinical measure. In this investigation, eight tympanometric gradient measures were calculated from tympanograms obtained from normal preschool age children. The measures were evaluated on the basis of distribution characteristics, relation to static admittance, and effect of pump speed. One of the measures--the pressure interval defined by a 50% reduction in peak eardrum admittance--appears to be the procedure of choice. Measurements obtained from abnormal ears are needed to evaluate the clinical utility of this measurement.